Pumping System and Method for Assisting a Patient&#39;s Heart

ABSTRACT

A cannula for a patient includes an elongate body having a length of at least 70 cm and a channel extending through the body defining a wall. The cannula includes a wire embodied within at least a portion of the wall. The body has a proximal end, a distal end having a tip opening through which the channel extends and a plurality of side holes through the wall in proximity to the tip for unimpeded flow of blood at the distal end. The cannula includes a barbed fitting at the proximal end. The cannula includes a suture wing for securing the elongated body to the patient. A system for assisting a patient&#39;s heart. A method for assisting a patient&#39;s heart.

This application is a continuation of U.S. patent application Ser. No.14/615,496 filed Feb. 6, 2015 and entitled “Pumping System and Methodfor Assisting a Patient's Heart”, which is published as United StatesPublication No. 2015/0165111 A1 and which is a continuation of U.S.patent application Ser. No. 14/035,087, filed Sep. 24, 2013 and entitled“Pumping System and Method for Assisting a Patient's Heart”, now U.S.Pat. No. 8,979,742, which is a continuation of U.S. patent applicationSer. No. 12/655,491, filed Dec. 31, 2009 and entitled “Pumping Systemand Method for Assisting a Patient's Heart”, now U.S. Pat. No. 8,562,519to Smith et al.

FIELD OF THE INVENTION

The present invention is related to assisting a patient's heart with acannula. (As used herein, references to the “present invention” or“invention” relate to exemplary embodiments and not necessarily to everyembodiment encompassed by the appended claims.) More specifically, thepresent invention is related to assisting a patient's heart with acannula where the cannula is of a length that extends from the patient'sgroin to the pulmonary artery.

BACKGROUND OF THE INVENTION

This section is intended to introduce the reader to various aspects ofthe art that may be related to various aspects of the present invention.The following discussion is intended to provide information tofacilitate a better understanding of the present invention. Accordingly,it should be understood that statements in the following discussion areto be read in this light, and not as admissions of prior art.

Patients with severe Right-sided circulatory/Right Ventricular Failurehave a significantly high mortality and morbidity caused by a multitudeof factors in multiple patient populations. Historically, RightVentricular Assist Devices have been placed for surgical patients,without a percutaneous or Cath lab option available. These surgicalRVAD's have been placed for patients with right inferior myocardialinfarction, acute right-sided ischemic myocardial, infarctions (withlarge left and right propagation), Cardiogenic Shock, LVAD created RVdysfunction, post transplant RV failure and pulmonary hypertension.Acute myocardial infarction and Cardiogenic shock have been treated withIABPs and maximal inotropic support, to which many patients becomerefractory to these treatment options. Surgically implanted LVADs cancreate a significant septal shift that leads to a dynamic change in theStarling curve that abruptly places patients into severe RV Failure.Patients bridged to transplant to from an LVAD with severe RV failure,can limit post transplant survival. Secondary Pulmonary Hypertensionleads to an exacerbation of RV failure in acute and chronic situations,which are commonly treated with LVADs.

The present invention, often referred to as a TandemHeart TransseptalCannula EF 72, (“THTC-EF-72”) has the capabilities to reach thePulmonary Artery from the Femoral Veins via a percutaneous insertion.Traditional RVADs have a cannula either primarily placed in the PA or agraft sewn onto the PA, then a cannula inserted through the graft. TheTHTC-EF 72 can be quickly visualized in the PA via Fluoroscopy and X-Raywith the aid of the distal markers in the cannula, verifying the properorientation of the outflow to the patient.

The THTC-EF 72 facilitates greater usage of the TandemHeart System in awider population of patients requiring Left-sided extracorporealcirculatory support. Torso length can limit the ability to access theLeft Atrium via percutaneous insertion. The THTC-EF 72 can be utilizedby either the Left or Right Femoral Vein, optimizing placement. Venousand Arterial blood mixing in patients can lead to an increase ofmorbidity and mortality.

Furthermore, traditional venoarterial ECMO (VA ECMO) is the currentstandard of care used to treat right ventricular failure and respiratoryfailure percutaneously. VA ECMO takes blood from the right atrium andpumps it through an oxygenator and back into the arterial circulationvia the femoral artery. VA ECMO bypasses the lungs and the heartcompletely. Therefore, residual blood is left stagnant in both the heartand lungs potentially leading to thrombosis and an inadequately unloadedright ventricle. Additionally, the arterial cannulation can lead toproblems including but not limited to bleeding, stroke, and infection.

Often, a patient has a problem with the right femoral vein (potentiallythrombosis) that prevents transseptal cannulation from the right leg. A62 cm cannula of the prior art cannot be used to access the left atriumfrom the left femoral vein because it is often too short. This problemwas not recognized until after commercialization. The cannula of thepresent invention solves that problem.

BRIEF SUMMARY OF THE INVENTION

The present invention pertains to a cannula for a patient. The cannulacomprises an elongate body having a length of at least 70 cm and achannel extending through the body defining a wall. The cannulacomprises a wire embodied within at least a portion of the wall. Thebody has a proximal end, a distal end having a tip opening through whichthe channel extends and a plurality of side holes through the wall inproximity to the tip for unimpeded flow of blood at the distal end. Thecannula comprises a barbed fitting at the proximal end. The cannulacomprises a suture wing for securing the elongated body to the patient.

The present invention pertains to a system for assisting a patient'sheart. The system comprises a pump adapted to be disposed outside thepatient which pumps blood. A system comprises a drainage cannula that isadapted to extend from the right atrium of the heart in fluidcommunication with the pump to provide blood to the pump. The systemcomprises a pulmonary artery cannula adapted to extend from thepatient's groin to the pulmonary artery of the patient to provide bloodto the pulmonary artery. The pulmonary artery cannula is in fluidcommunication with the pump, whereby the heart's right ventricle isessentially bypassed by draining the right atrium and pumping blood intothe pulmonary artery thereby allowing the right ventricle of the patientto rest and enable right ventricular support.

The present invention pertains to a method for assisting a patient'sheart. The method comprises the steps of inserting the tip of a cannulainto a right femoral vein of a patient. There is the step of moving thetip through the right femoral vein until side holes of the cannula inproximity to the tip are disposed in the pulmonary artery. There is thestep of inserting a tip of a drainage cannula into the patient. There isthe step of moving the tip of the drainage cannula through the patientuntil the tip of the drainage cannula is disposed in the right atrium.There is the step of connecting an inlet of a pump to the drainagecannula with connective tubing. There is the step of connecting anoutlet of the pump to the pulmonary artery cannula with connectivetubing. There is the step of connecting an outlet of the oxygenator tothe cannula with connective tubing. There is the step of securing thepump to the patient. There is the step of pumping blood received by thepump from the drainage cannula into the pulmonary artery through thepulmonary artery cannula to provide right ventricular and respiratorysupport without having to bypass the heart and lungs.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING

In the accompanying drawings, the preferred embodiment of the inventionand preferred methods of practicing the invention are illustrated inwhich:

FIG. 1 is a schematic representation of the system of the presentinvention.

FIG. 2A is a side view of the cannula of the present invention.

FIG. 2B is an axial view of the tip of the cannula of FIG. 2A.

FIG. 2C is an exploded side view of the cannula of FIG. 2A.

FIG. 3 is a side view of an introducer.

FIG. 4 is a side view of a dilator.

FIG. 5 is a perspective view of a suture wing.

FIG. 6A is a side view of the cannula of the present invention.

FIG. 6B is a detail view of detail 6B in FIG. 6A.

FIG. 6C is a detail view of detail 6C in FIG. 6A.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to the drawings wherein like reference numerals refer tosimilar or identical parts throughout the several views, and morespecifically to FIGS. 2 a, 2 b, 2 c and 6 thereof; there is shown acannula 10 for a patient. The cannula 10 comprises an elongate body 12having a length of at least 70 cm and a channel 14 extending through thebody 12 defining a wall 16. The cannula 10 comprises a wire 22 embodiedwithin at least a portion of the wall 16. The body 12 has a proximal end18, a distal end 20 having a tip 24 opening through which the channel 14extends and a plurality of side holes 26 through the wall 16 inproximity to the tip 24 for unimpeded flow of blood at the distal end20. The cannula 10 comprises a barbed fitting 28 at the proximal end 18.The cannula 10 comprises a suture wing 30, as shown in FIG. 5, forsecuring the elongated body 12 to the patient. The pump 38 can be anycentrifugal, axial, mixed, or roller pump that can produce adequateflowrates through the system. Several examples include but are notlimited to the TandemHeart, Medtronic Biomedicus (BP-50, BP-80,BP-80.times.), Jostra Rotaflow, Levitronix Centrimag, Terumo Capiox,Sarns Delphin, Cobe Revolution, and others. The pump 38 can be securedto the patient for instance with a holster 52 that holds the pump with astrap or in a pocket. The holster 52 can be wrapped around the leg ofthe patient.

The distal end 20 may be curved for natural anatomical placement fromthe inferior vena cava into the left atrium of. At least a portion ofthe elongate body 12 may have insertion depth markings 34. The tip 24may have radiopaque markers 32 to aid in visualization.

The present invention pertains to a system 36 for assisting a patient'sheart, as shown in FIG. 1. The system 36 comprises a pump 38 adapted tobe disposed outside the patient's which pumps blood. A system 36comprises a drainage cannula 40 that is adapted to extend from the rightatrium of the heart in fluid communication with the pump 38 to provideblood to the pump 38. The system 36 comprises a pulmonary artery cannula42 that is at least 70 cm in length and adapted to extend from thepatient's groin to the pulmonary artery of the patient to provide bloodto the pulmonary artery. The pulmonary artery cannula 42 is in fluidcommunication with the pump 38, whereby the heart's right ventricle isessentially bypassed by draining the right atrium and pumping blood intothe pulmonary artery thereby allowing the right ventricle of the patientto rest and enable right ventricular support.

The system 36 may include an oxygenator 44 in fluid communication withthe pump 38 which receives blood pumped by the pump 38 and oxygenatesthe blood, and with the pulmonary artery cannula 42 to provide bloodoxygenated by the oxygenator 44 to the pulmonary artery. The oxygenator44 can be any of the spiral wound sheet membrane type or any of thehollow fiber membrane type including but not limited to the TerumoCapiox, Medtronic Minimax, Medtronic ECMO Oxygenators, MedtronicAffinity, Jostra Quadrox, Gish Vision, Cobe Optima, and others. Acontroller that may be used for the pump is described in U.S. Pat. No.6,808,508 or in U.S. patent application Ser. No. 11/328,961; now U.S.Pat. No. 8,550,973 to Magovern et al., both of which are incorporated byreference herein.

The present invention pertains to a method for assisting a patient'sheart. The method comprises the steps of inserting the tip 24 of acannula 10 having a length of at least 70 cm into a right femoral veinof a patient. There is the step of moving the tip 24 through the rightfemoral vein until side holes 26 of the cannula 10 in proximity to thetip 24 are disposed in the pulmonary artery. There is the step ofinserting a tip 24 of a drainage cannula 40 into the patient. There isthe step of moving the tip 24 of the drainage cannula 40 through thepatient until the tip 24 of the drainage cannula 40 is disposed in theright atrium. There is the step of connecting an inlet of a pump 38 tothe drainage cannula 40 with connective tubing. There is the step ofconnecting an outlet of the pump 38 to the pulmonary artery cannula 42with connective tubing. There is the step of connecting an outlet of theoxygenator 44 to the cannula 10 with connective tubing. There is thestep of securing the pump 38 to the patient. There is the step ofpumping blood received by the pump 38 from the drainage cannula 40 intothe pulmonary artery through the pulmonary artery cannula 42 to provideright ventricular and respiratory support without having to bypass theheart and lungs.

There may be the steps of connecting the outlet of the pump 38 to aninlet of an oxygenator 44 with connective tubing; connecting an outletof the oxygenator 44 to the pulmonary artery cannula 42 with connectivetubing; and the pumping step may include the step of pumping bloodreceived by the pump 38 from the drainage cannula 40 through theoxygenator 44, where oxygen is provided to the blood and carbon dioxideis removed from the blood, and into the pulmonary artery through thepulmonary artery cannula 42. The step of inserting the tip 24 of thedrainage cannula 40 may include the step of inserting the tip 24 of thedrainage cannula 40 into the left femoral vein.

In the operation of the invention, the THTC-EF 72 Set consists of threecomponents: a 21 Fr cannula, an introducer 48 (see FIG. 3), and a 14/21Fr Two-Stage dilator 46 (see FIG. 4).

The THTC-EF 72 cannula (FIG. 6) has a 21 Fr dipped polyurethane body 12with a spring-like coil of wire 22 embedded into the cannula 10 wall 16.The cannula 10 has a working length of about 72 cm. The wire-reinforcedarea allows for clear visualization under fluoroscopy and for resistanceto kinking. The wire-reinforcing also permits a thin-walledconstruction. This feature allows for a larger inside diameter (lumen)while maintaining the 21 Fr outside diameter. Printing on a region ofthe cannula 10 which is not wire-reinforced indicates the area where aclamp should be applied as needed during the set-up or removal process.The distal end 20 of the cannula 10 is curved for natural anatomicalplacement from the inferior vena cava into the left atrium. The cannula10 tip 24 has 14 side holes 26 in addition to the tip 24 opening forunimpeded inflow of blood at the distal end 20, a barbed fitting 28 atthe proximal end 18, and insertion depth markings 32 from 40 to 72 cmmeasured from the distal end 20. The tip 24 of the THTC-EF 72 cannula 10contains radiopaque markers 32 which are embedded in the cannula 10 toaid in visualization. The cannula 10 also includes a Suture Wing 30 toprovide a means for securing the cannula 10 to the patient. The printingon the cannula 10 is oriented to show the clinician that the distal tip24 curves to the right when the printing is on the top of the cannula 10body 12. FIG. 6 shows a 21 Fr Wire-Reinforced THTC-EF 72 cannula.

The Introducer 48 is a tube that fits inside the THTC-EF 72 (FIG. 3)during insertion into the patient's vasculature. The Introducer 48consists of a tube which is insert-molded to a male Luer hub. Ahemostasis cap is used on the THTC-EF 72 Introducer 48 to cover theproximal end 18 of the THTC-EF 72 cannula 10 to prevent blood loss.Small holes in the side of the introducer 48 at both the proximal anddistal ends facilitate aspiration. The introducer 48 has a 14 Fr outsidediameter.

The purpose of the Introducer 48 is to guide the cannula 10/introducer48 assembly over a guidewire, across the septum, into the left atrium,and to provide a lumen for the injection of contrast media to help guidethe placement of the cannula 10. Contrast media is emitted from theproximal tip of the introducer 48. FIG. 3 shows a THTC-EF 72 Introducer48.

The dilator 46 (FIG. 4) is a slightly stiffer, stepped 2-diameter tubewhich is inserted prior the cannula 10/introducer 48 assembly. The innerlumen of the dilator 46 allows the dilator 46 to be inserted into thepatient over a guidewire previously placed into the left atrium. Theproximal end 18 of the THTC-EF 72 dilator 46 is formed to aid ingripping. The Dilator 46 serves to dilate the hole in the fossa ovalisand facilitate access to the left atrium. It is withdrawn and discardedafter use. FIG. 4 shows a 14/21 Fr. dilator 46. The cannula 10 is theonly component of the cannula/dilator/oburator set left in place duringtherapy. Its purpose is to provide the conduit for blood flow from thepump 38.

Mechanical Characteristics:

2 stage stepped Single lumen Straight, single tapered single Shape tube,curved tip lumen tube lumen tube Radi- Yes Yes Yes opaque Overall 34.25in. (87 cm) 36.25 in. (92.1 cm) 32.65 in. (82.9 cm) length Working  28.4in. (72 cm) 35.35 in. (89.8 cm) 32.65 in. (82.9 cm) length Outer 21 Fr14 Fr. 14/21 Fr. diameter Inner 0.232 in. (.59 cm) 0.111 in. (0.28 cm)0.175 in. (0.44 cm) diameter Distal Tapered with Tapered with 0.041Tapered 14 Fr. to 21 tip an end in. ± 0.002 in. Fr. with 0.040 openingof (1.0 mm) opening in. ± 0.003 in. 0.186 in. (.47 at tip (0.9 mm)diameter cm) and 7 opening at tip pairs (14 total) of side holes 0.094in. (2.4 mm) diameter Connec- ⅜ in. barbed Luer, ABS None torsconnector, Polycarbonate Materials 42D Tecoflex PolyethylenePolyurethane, polyurethane, (Equistar Isoplast, Polyethylene, ABS.Petrothene), medical-grade radiopacifier radiopacifer stainless steel(barium sulfate) (bismuth wire, Tantalum subcarbonate) Dot

Manufacture

The cannula 10 is manufactured using a urethane dipping process on asteel mandrel to create the body 12 of the device. This allows forone-piece construction of the cannula 10 body 12, and provides athin-wall with maximal flexibility. The bare mandrel is dipped into thepolyurethane, and a flat wire spring is then applied over the dippedmandrel. Subsequently dipping into polyurethane completely encapsulatesthe wire spring.

A one inch portion of the distal tip 24 of the cannula 10 is left freeof wire reinforcement to allow for side holes 26 to be punched near thecannula 10 tip 24. As the lack of wire-reinforcement makes the cannula10 tip 24 invisible under fluoroscopy, three tantalum markers 32 areadded to distal portion of the cannula 10 tip 24. Following the additionof the markers 32, the cannula 10 tip 24 receives additional dips in anincreased durometer polyurethane, to provide structural integrity forthis region. A 50.degree. bend is then set into the cannula 10approximately 3 inches from the distal tip 24 of the cannula 10.Following the bending operation, depth markings 34 are printed on theoutside of the cannula 10.

A portion of the proximal end 18 of the cannula 10 is also left withoutwire-reinforcement to allow for clamping. A ⅜″.times.⅜″ barbed connectoris inserted into the proximal end 18 of the cannula 10 to allow forconnection to extracorporeal equipment. The Introducer 48 is an extrudedtube which is insert molded into a male luer hub. The Dilator 46 is alsoformed from an extruded tube, and tipped to provide a region that stepsfrom 14 Fr to 21 Fr.

Right Heart Assist

Pulmonary Artery Cannula 42 (the Invention) Insertion Procedure

The invention involves a cannula 10 inserted into the pulmonary artery(PA) for right heart support. The cannula 10 delivers flow back to thepatient from the pump 38. The first step is to use a percutaneous EntryNeedle to access the Right Femoral Vein (RFV). A guidewire is theninserted through needle until the tip of the guide-wire sits in theupper portion of the inferior vena cava/right atrium (IVC/RA) junction.The needle can then be removed and a pulmonary wedge catheter insertedover the guidewire into the PA. The guidewire tip 24 is then threadedinto the PA, and the wedge catheter is removed. The right femoral veinis then serially dilated and the proposed invention is threaded alongthe guidewire into the right femoral vein. The introducer can be removedwhen the cannula 10 is in the right ventricle. The cannula 10 can thenbe threaded over the wire 22 up into the PA. The curve in the cannula 10is a feature that helps it make the turn from the right ventricle intothe PA. Once the cannula's position is acceptable, theintroducer/guidewire assembly is removed and the cannula 10 is clamped.The TandemHeart transseptal cannula 10 is secured to the patient's legusing suture or the suture wing 30 or suture ring feature. Anotherfeature of the cannula 10 is the skin markings 34 that can be used tohelp track cannula 10 placement and ensure no cannula 10 movement duringsupport.

Right Atrium Cannula—Used in Conjunction with the PA Cannula InsertionProcedure

The right atrium can be cannulated as the inflow to the pump 38 by firstusing a percutaneous entry needle to access the Left Femoral Vein (LFV).A guidewire is placed through the needle until the tip 24 sits in theRA. The needle can then be removed and the vessel can be seriallydilated. The inflow cannula 10 can be inserted over the guidewire untilit resides in the RA/IVC junction. Once the cannula's position isacceptable, the introducer and guidewire can be removed and the cannula10 can be clamped. The cannula 10 can be secured to the patient's legusing suture or suture wing 30 or suture ring if available.

Connecting to the Pump 38

Pre-prime the Pump 38 by slowly filling the blood chamber of the Pump 38with Saline, making sure to remove all air, then clamp the tubings belowthe saline line to insure proper wet-to-wet connections. Perform awet-to-wet connection between the Pump 38 inlet and the Right Atriumcannula 10, up to the first cannula connector barb. Check for airbubbles, if none are present, finish pushing tubing over the cannula 10connector. Perform another wet-to-wet connection between the Pump 38outlet and the Pulmonary artery cannula 42, which is in the PA, up tothe first cannula 10 connector barb. Check for air bubbles, if none arepresent, finish pushing tubing over the cannula 10 connector.

Initiate support by turning the pump 38 on at low speed (RPM). Releasetubing clamps on the inlet side of the Pump 38 and check for air in theoutlet side of the pump 38. If there is no air present, release theremaining tubing clamps. Adjust speed (RPM) until desired flow isachieved. Caution should be taken not to over-drive the pump 38, whichcould result in excessive PA pressures and overloading of the lungs.

Left Heart Assist

Transseptal Cannulation

The transseptal cannula 10 is intended for providing a means for leftventricular bypass when connected to a blood pump which returns blood tothe patient via the femoral artery or other appropriate site. Thecannula 10 uses a wirewound construction which prevents kinking. Thecannula 10 is longer, contains insertion depth markers 34, and a meansfor securing the device to the patient (i.e. a suture wing 30 and suturerings). The cannula 10 also includes radiopaque markers 34 at the tip 24for correct device placement in the left atrium. The transeptal cannula10 provides an extended length when cannulation is necessary from theleft femoral vein. It is believed that no other cannula 10 has ever beenable to accomplish this.

Insertion Procedure

Use standard transseptal puncture technique to gain access into the leftatrium from the femoral vein. Dilate the transseptal puncture site(fossa ovalis) with a transseptal catheter. Introduce an appropriateguidewire into the left atrium. Remove the transseptal catheter leavingthe guidewire in the left atrium. Advance the two stage dilator 46 overthe guidewire into the left atrium to dilate the fossa ovalis. Removethe two stage dilator 46 and assemble the Introducer to the transseptalcannula 10. Advance the introducer/cannula over the guidewire into theleft atrium as follows: Load the introducer/cannula onto the guidewireand advance it until the assembly abuts the Fossa Ovalis. Underfluoroscopy or cineangiography, use the radiopaque markers 32 located inthe cannula tip 24 and the end of the wire reinforced section of thecannula 10 body 12 to guide placement of cannula 10 into the leftatrium. Note the location of the radiopaque markers 32 in the tip 24 ofthe cannula 10 and record the insertion depth using the depth markers 34on the side of the cannula 10. Remove the guidewire and introducer andclamp the transseptal cannula 10 at the clamping zone indicated on thecannula 10 as the introducer is pulled back.

Insert the arterial cannula using standard procedures and protocols.Make a wet-to-wet connection between the transseptal cannula and thetubing that is attached to the inflow port of the pump 38. Suture thetransseptal cannula securely to the patient's leg using the suture wing30 and suture rings. The suture rings may be positioned anywhere alongthe insertable length of the cannula to provide additional means ofsecurement. Make a second wet-to-wet connection between the pump 38outflow and the arterial cannula. Ensure that no air exists in thetubing and start the pump 38 to the desired flowrate.

The 72 cm long cannula 10 can enable right ventricular and respiratorysupport via the groin without having to bypass the heart and lungs as inVA ECMO. The 72 cm cannula is implanted on the venous side and thereforeavoids the arterial cannulation typically used in VA ECMO. The circuitconsists of the 72 cm cannula, a pump 38, an oxygenator 44, a drainagecannula 40, and connective tubing. The tip of the drainage cannula 40 isplaced in the right atrium. The inlet of the pump 38 is connected to thedrainage cannula 40 with connective tubing. The outlet of the pump 38 isconnected to the inlet of the oxygenator 44 with connective tubing. Theoutlet of the oxygenator 44 is connected to the 72 cm cannula whose tip24 is placed into the pulmonary artery. The 72 cm cannula is insertedinto the PA as described in the procedure referenced earlier. Oxygen orroom air is used as the ‘sweep gas’ through the oxygenator 44 to provideoxygen to the blood and carbon dioxide removal from the blood. The rightventricle is essentially bypassed by draining the right atrium andpumping into the pulmonary artery thereby allowing the right ventricleto rest.

Utilizing the 72 cm cannula 10 would allow the ECMO circuit to deliveroxygenated blood directly to the lungs and possibly help rest/decompressthe Right side (i.e. TandemRight cannulation with an oxygenator 44).

Although the invention has been described in detail in the foregoingembodiments for the purpose of illustration, it is to be understood thatsuch detail is solely for that purpose and that variations can be madetherein by those skilled in the art without departing from the spiritand scope of the invention except as it may be described by thefollowing claims.

What is claimed is:
 1. A pumping system for assisting a human patient'sheart, comprising: a blood pump; a drainage cannula adapted for fluidcommunication with an inlet to the blood pump to provide blood to theblood pump; and a blood supply cannula adapted for fluid communicationwith an outlet of the blood pump to provide blood to the patient's heartarterial system, at least one of the drainage cannula and the bloodsupply cannula further comprising: an elongated body defining a channelextending through the elongated body, the elongated body having aproximal end and a distal end having a distal tip, the distal enddefusing at least one of a tip opening communicating with the channeland at least one side hole in proximity to the distal tip andcommunicating with the channel for outflow of blood at the distal end,wherein the drainage cannula has a length to extend from the patient'sgroin to the patient's right atrium and the blood supply cannula has alength to extend from the patient's groin to the patient's heartarterial system, whereby, when the blood pump operates, the patient'sheart and lungs are essentially bypassed by draining the right atrium ofblood and pumping blood into the patient's heart arterial system therebyallowing the patient's ventricles to rest and establishing ventricularsupport.
 2. The pumping system as claimed in claim 1, wherein the distalend of the elongated body is curved for natural anatomical placementwithin the patient's heart.
 3. The pumping system as claimed in claim 1,wherein at least a portion of the elongated body has insertion depthmarkings.
 4. The pumping system as claimed in claim 1, wherein thedistal tip has radiopaque markers to aid in visualization.
 5. Thepumping system as claimed in claim 1, further comprising a bloodoxygenator between the blood supply cannula and the blood pump outlet tooxygenate the blood received from the patient's heart into the bloodpump, the blood pump supplying oxygenated blood to the patient via theblood supply cannula.
 6. A method for assisting a human patient's heart,comprising: connecting a drainage cannula to an inlet to a blood pump toprovide blood to the blood pump, the drainage cannula having a length toextend from the patient's groin to the patient's right atrium;connecting a blood supply cannula to an outlet of the blood pump toprovide blood to the patient, the blood supply cannula having a lengthto extend from the patient's groin to the patient's heart arterialsystem; and operating the blood pump such that the patient's ventriclesare essentially bypassed by draining the right atrium of blood andpumping blood into the patient's heart arterial system thereby allowingthe patient's ventricles to rest and establishing ventricular support.7. The method as claimed in claim 6, wherein at least one of thedrainage cannula and the blood supply cannula further comprises: anelongated body defining a channel extending through the elongated body,the elongated body having a proximal end and a distal end having adistal tip, the distal end defining at least one of a tip openingcommunicating with the channel and at least one side hole in proximityto the distal tip and communicating with the channel for outflow ofblood at the distal end.
 8. The method as claimed in claim 7, whereinthe distal end of the elongated body is curved for natural anatomicalplacement within the patient's heart.
 9. The method as claimed in claim7, wherein at least a portion of the elongated body has insertion depthmarkings.
 10. The method as claimed in claim 7, wherein the distal tiphas radiopaque markers to aid in visualization.
 11. The method asclaimed in claim 6, further comprising oxygenating the blood receivedfrom the patient's heart into the blood pump, the blood pump supplyingoxygenated blood to the patient via the blood supply cannula.
 12. Apumping system for assisting a human patient's heart, comprising: ablood pump; a transseptal cannula adapted for fluid communication withan inlet to the blood pump to provide blood to the blood pump; and anarterial cannula adapted for fluid communication with an outlet of theblood pump to provide blood to the patient's heart, at least one of thetransseptal cannula and the arterial cannula further comprising: anelongated body defining a channel extending through the elongated body,the elongated body having a proximal end and a distal end having adistal tip, the distal end defining at least one of a tip openingcommunicating with the channel and at least one side hole in proximityto the distal tip and communicating with the channel for outflow ofblood at the distal end, wherein the transseptal cannula is furtherconfigured to cross the patient's atrial septum to extend into thepatient's left atrium, whereby the patient's left ventricle isessentially bypassed by draining the left atrium when blood is pumped bythe blood pump into the patient's heart arterial system via the arterialcannula thereby allowing the patient's left ventricle to rest andestablishing left ventricular support.
 13. The pumping system as claimedin claim 12, wherein the transseptal cannula has a length to extend fromthe patient's groin to the patient's heart.
 14. The pumping system asclaimed in claim 12, wherein the arterial cannula has a length to extendfrom the patient's groin to the patient's heart.
 15. The pumping systemas claimed in claim 12, wherein the distal end of the elongated body iscurved for natural anatomical placement within the patient's heart. 16.The pumping system as claimed in claim 12, wherein the distal end of theelongated body is curved for natural anatomical placement from theinferior vena cava into the left atrium of the patient's heart.
 17. Thepumping system as claimed in claim 12, wherein at least a portion of theelongated body has insertion depth markings.
 18. The pumping system asclaimed in claim 12, wherein the distal tip has radiopaque markers toaid in visualization.
 19. The pumping system as claimed in claim 12,further comprising a blood oxygenator between the arterial cannula andthe blood pump outlet to oxygenate the blood received from the patient'sheart into the blood pump, the blood pump supplying oxygenated blood tothe patient via the arterial cannula.
 20. A method for assisting a humanpatient's heart, comprising: connecting a transseptal cannula with aninlet to a blood pump to provide blood to the blood pump; connecting anarterial cannula with an outlet of the blood pump to provide blood tothe patient's heart; crossing the patient's atrial septum using thetransseptal cannula whereby the transseptal cannula extends into thepatient's left atrium; and operating the blood pump such that thepatient's left ventricle is essentially bypassed by draining the leftatrium and pumping blood into the patient's heart arterial system viathe arterial cannula thereby allowing the patient's left ventricle torest and establishing left ventricular support, wherein at least one ofthe transseptal cannula and the arterial cannula further comprises: anelongated body defining a channel extending through the elongated body,the elongated body having a proximal end and a distal end having adistal tip, the distal end defining at least one of a tip openingcommunicating with the channel and at least one side hole in proximityto the distal tip and communicating with the channel for outflow ofblood at the distal end.
 21. The method as claimed in claim 20, whereinthe transseptal cannula has a length to extend from the patient's grointo the patient's heart.
 22. The method as claimed in claim 20, whereinthe arterial cannula has a length to extend from the patient's groin tothe patient's heart.
 23. The method as claimed in claim 20, wherein thedistal end of the elongated body is curved for natural anatomicalplacement within the patient's heart.
 24. The method as claimed in claim20, wherein the distal end of the elongated body is curved for naturalanatomical placement from the inferior vena cava into the left atrium ofthe patient's heart.
 25. The method as claimed in claim 20, wherein atleast a portion of the elongated body has insertion depth markings. 26.The method as claimed in claim 20, wherein the distal tip has radiopaquemarkers to aid in visualization.
 27. The method as claimed in claim 20,further comprising oxygenating the blood received from the patient'sheart into the blood pump, the blood pump supplying oxygenated blood tothe patient via the arterial cannula.